Transplanted Hair Thinning & Loss

[mattny]

Has anyone experienced a loss or thinning in the transplanted areas?

I thought that these hairs are permanent?

It's been about 4 1/2 years since my procedure.

But I'm experiencing a thinning, and it doesn't seem to be a cycle of hair stages, cuz i've noticed that within the past 4years as a normal occurrence. But, this is different. All the hairs in the transplanted area are thinner than anytime before, and seem to progressively thin out.

 

I religiously take finasteride 5mg (cut into quarters) each day

Minoxidil twice daily.

 

Very worried and concerned!!

 

Thanks.

Edited May 19, 2015 by mattny

[Dannyboy78]

Hi there mattny,I'm experiencing the same thing and I had my fue done just over 4 years ago.i like you have religiously used finestrade and regain every day,I've logged a complaint where I had fue done but I won't say where until it is resolved,I'm also looking for any helpful answers on here to find out what's gone wrong because like yourself I thought they were perminante,so come on guys all ideas will help

[1978matt]

Donor areas are unlikely to be 100% safe and what Unger (?) I think found in the 1950s was that 85% of people kept 85% of their hair up to the age of 65, within the 'strip' safe zone.

 

FUE is a bit more of a lottery when the extractions are taken from a wide area with the fringe areas most prone to disappearing early.

[mattny]

i did not have a FUE. It was a strip.

 

Also, Dannyboy, do you experience any sort of chronic anxiety. I have recently had a breakup with a girl and it has caused a bit of insomnia and anxiety. I'm wondering if this might be causing some of this... you know higher cortisol levels...etc.

 

But, for sure, it definitely does seem that I'm having a general lose in the transplanted areas over time.

 

How are you going about your complaint...cuz maybe i should also.

 

Thanks!

[mattny]

1978 matt.... you hair looks thick in front and you were receding more than i was. Do you still maintain a think frontal area? Like i said i also had the FUT (strip). How long has it been since you got your procedure done?

[Swooping]

How old are you?

[mattny]

Im 47

[Swooping]

Im 47

 

At your age it's more common than you think that the donor is beginning to lose it's strength. Whether that is in the form of thinning, a shift in telogen/anagen ratio or a increase of vellus to terminal ratio or just a decreased follicular count etc.

 

To simply put it the more older you get the more susceptible your cells get to any stress. This can be from androgens in relation to the pathology of androgenetic alopecia but this can also include a other pathology namely senescent alopecia for instance;

 

Androgenetic alopecia (AGA) is characterized by androgen mediated miniaturization of the hair follicle in susceptible individuals. Senescent alopecia (SA) is the diffuse scalp hair thinning that is seen with advanced age even in individuals without a family history of hair loss. Differences in follicular counts, anagen/telogen percentages, and terminal/vellus hair ratios have been reported

 

Recently there was a microarray analysis done in subjects with AGA and SA and a marked difference in gene expression was found.

 

It's kinda dynamic as you can see, it goes even deeper.

 

Anyway all this "stress together" may lead to transplanted grafts getting a marked decrease of quality the more you age.

 

So what can you do? Not much actually, you can look into dutasteride for more DHT inhibition to reduce the stress on your hair follicles. Assuming the current thinning is related to AGA then you might have a chance of doing something good. However if it's related to SA (senescent alopecia) then you can't really do much.

 

Other then that make sure your thyroid levels are in check.

[1978matt]

1978 matt.... you hair looks thick in front and you were receding more than i was. Do you still maintain a think frontal area? Like i said i also had the FUT (strip). How long has it been since you got your procedure done?

 

Yeah, it is still the same but it has only been 21 months post op. I am also 36.5 years old.

 

Over the years I expect it to thin out slightly but by that time I should be fully grey (which should compensate a little). I think one of my uncles was white haired by the time he was 45 and I'm following that trend.

[mattny]

Swooping, that doesn't really make sense. Because as they doctors tell us, the donor hairs are coming from an area in back of the head that are genetically programmed not to fall out. The hairs in back of my head are not thinning, even as i age. So, neither should the transplanted hairs that came from the back of my head.

 

If you are right, then what the Doctor(s) tell us is false. They (even my Doctor) say that those hairs are permanent, and should naturally shed, but will always come back. Even if a person experiences higher stress levels; once that stress is gone, the hairs will return. This is in fact what my Doctor told me.

 

So then, what you're saying is... its not where the hairs come from, its where they are placed that will make the difference in future sustainability.

 

Are you saying that cuz the DHT typically accumulates at the top regions of the scalp?

Edited May 19, 2015 by mattny

[mattny]

Senescent alopecia was originally thought to affect people aged 50 years or older with no family history or evidence of pattern balding. It was described as a diffuse thinning involving the whole scalp due to a steady decrease in thick terminal hairs, but without evidence of increased miniaturization. Senescent alopecia is not a primary diagnosis in this clinic. Most possible examples of it are assumed to be androgenetic or diffuse alopecia. In the study reported here, horizontal sections of 2149 scalp specimens from individuals with male and female pattern and diffuse alopecia, as well as from normal controls, were examined, and their follicular counts were recorded and sorted into decades. The decade of 20 to 29 years contained a significant number of patients and was used for baseline follicular counts for comparison with all succeeding decades up to age 99 years. A reduction of 15% below baseline was considered significant. In 10.6% of patients with male pattern alopecia, the age of onset of a significant reduction in follicular counts was 50 years; in 5.7% of patients with female pattern alopecia it was 70 years, and in 2.0% of patients with diffuse alopecia it was 80 years. These data suggest that most cases of significant hair loss in the elderly are androgen driven. The few patients with deteriorating diffuse alopecia may be the exception. The study concluded that old age is not a significant cause of hair loss.

 

Source: http://www.ncbi.nlm.nih.gov/pubmed/21146732

[mattny]

My brother is 4 years older than me and has a thick crop.... possibly due to all the 420 he smoked over the years.

 

My grandfather on my mother's side had a thick crop.. and he was 80 something...

 

My point being, age is really not a significant factor.

[Swooping]

Swooping, that doesn't really make sense. Because as they doctors tell us, the donor hairs are coming from an area in back of the head that are genetically programmed not to fall out. The hairs in back of my head are not thinning, even as i age. So, neither should the transplanted hairs that came from the back of my head.

 

If you are right, then what the Doctor(s) tell us is false. They (even my Doctor) say that those hairs are permanent, and should naturally shed, but will always come back. Even if a person experiences higher stress levels; once that stress is gone, the hairs will return. This is in fact what my Doctor told me.

 

So then, what you're saying is... its not where the hairs come from, its where they are placed that will make the difference in future sustainability.

 

Are you saying that cuz the DHT typically accumulates at the top regions of the scalp?

 

It isn't true the hair at the back even at the donor safe zone never deteriorates in quality as men age. This is not always the case but it can happen in some people. This can happen in all sort of forms just solely thinning of the hair or literally a decrease in follicular count etc.Thinning of the hair only (diameter) can literally give you a less appealing cosmetic difference. Also this doesn't have to be AGA depended it can be SA (1) depended too, or both.

 

Stress can lead to telogen effluvium. It is marked in a shift to telogen ratio where follicles enter a resting phase. Normally it's around 10-15%, in TE this shifts to a higher percentage. It's more prominent in women than men. It can be acute or chronic. Often you would notice a (period) of huge shedding accompanied with this condition. But you describe it as "progressive thinning".

 

And, yes when you transplant a graft to the top of the head, you are only transplanting the micro-environment of the hair follicle. Not the dermal macro-environment. In studies marked differences have been shown in the scalp in the back of the had and the top of the head. For instance in 5ar2 expression, aromatase expression etc. So hypothetically your transplanted hair follicles might have a harder time at the top of your head than at the back, especially when you get older. Perhaps this stretches to far ends but it really does get that dynamic. If you need references to studies just shout.

 

But yeah if it is due to stress then don't worry man. Try to relax and it will all grow back soon :cool:.

 

Microarray analysis of androgenetic and senescent alopecia: comparison of gene expression shows two distinct profiles.

 

(1) http://www.ncbi.nlm.nih.gov/pubmed/23886704

[Swooping]

Also read this study; Oxidative Stress in Ageing of Hair.

 

And this one some more hard data;

 

http://www.pgscience.com/files/pdf/Dr._Thomas_Dawson/Ch14_Effects_Aging_Flagler_Robbins_Dawson.pdf (Especially take a look here on the Japanese men with their reduction in hair diameter as they age, considering they have godly hair genes.)

 

To your response btw;

 

My point being, age is really not a significant factor.

 

Age is a huge significant factor. Even in the assumption that senescent alopecia isn't a different pathology, age is a huge factor for androgenetic alopecia.

 

No wonder that AGA is progressive and more prominent while androgen levels plummet as you get older.

 

I understand that a individual can be 400kg's, smoke 4 packs a day, sit in the sun whole day and be a NW1 at the age of 80 with perfect donor quality. That's not the point. Everyone is different.

Edited May 19, 2015 by Swooping
Added something

[mattny]

Thanks Swooping.

 

I think its stress and anxiety. The thinning seems a little patchy.

 

I was thinking of doing it again in the front half of my head... to make it more thick.

[Swooping]

Most likely indeed. Will grow back then no problem! You are are still pretty young too. Was just displaying that it's not as black & white that you can't lose some of your donor hair in the long run or quality of your donor hair.